Article ID | Journal | Published Year | Pages | File Type |
---|---|---|---|---|
8737373 | Diagnostic Microbiology and Infectious Disease | 2017 | 5 Pages |
Abstract
Given constantly high or even rising incidences of both colonization and infection with vancomycin-resistant enterococci (VRE), timely and accurate identification of carriers in high-risk patient populations is of evident clinical importance. In this study, a two-tier approach consisting of PCR-based screening and cultural confirmation of positive results is compared to the conventional approach solely based on culture on selective media. The 2-tier strategy was highly consistent with the conventional approach, and was found to possess high sensitivity and specificity (93.1% and 100%, respectively). The introduction of the PCR-based combined VRE screening approach significantly (PÂ <Â 0.0001) reduced median overall time to result by 44.3Â hours. The effect was found to be most pronounced in VRE negative samples. Positive vanA PCR was highly consistent with culture (PPV: 92.0%, 95% CI: 72.5-98.6%, NPV: 99.6%, 95% CI: 98.9-99.6%), thus allowing for preliminary reporting of VRE detection. In contrast, a vanB positive PCR does not allow for preliminary reporting (PPV: 58.5%, 95% CI: 44.2-71.6%, NPV: 99.8%, 95% CI: 99.2-100%). The introduction of a molecular assay for rapid detection of VRE from rectal swabs combined with cultural confirmation proved to be reliable and time saving, especially in a setting of low VRE prevalence and predominance of vanA positive strains.
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Authors
Anna Both, Gefion C. Franke, Nadine Mirwald, Marc Lütgehetmann, Martin Christner, Eva-Maria Klupp, Cristina Belmar Campos, Henning Büttner, Martin Aepfelbacher, Holger Rohde,